What is new in research on transcranial magnetic stimulation?
In this Research Roundup, we explore new studies on transcranial magnetic stimulation (TMS), with a special focus on the efficacy of TMS as a treatment for major depressive disorder (MDD), obsessive-compulsive disorder (OCD), and bipolar disorder.
Efficacy of TMS as a Treatment for MDD
Investigators conduced a review of published meta-analyses of randomized controlled trials evaluating the safety and efficacy of TMS for the treatment of MDD. They comprehensively analyzed the available evidence and offered insight into the effectiveness of TMS as a treatment option. The investigators also conducted a re-analysis of the meta-analyses to further investigate the efficacy of TMS.
“Our re-analysis revealed the direction and magnitude of treatment effects vary widely across different settings,” the investigators concluded. “We also found high risk of bias in the majority of included systematic reviews and presence of small-study effects in some meta-analyses. Because of these reasons, we argue TMS for MDD may not be as effective and potentially less tolerated in some populations than current evidence suggests.”
Brini S, Brudasca NI, Hodkinson A, et al. Efficacy and safety of transcranial magnetic stimulation for treating major depressive disorder: an umbrella review and re-analysis of published meta-analyses of randomised controlled trials. Clin Psychol Rev. 2023;100:102236.
TMS for the Treatment of OCD
Investigators evaluated the efficacy of TMS for the treatment of OCD. They conducted a systematic review and meta-analysis of multiple studies, finding that TMS was associated with a significant reduction in OCD symptoms in comparison to sham treatment. The investigators also identified several potential neural targets for TMS in the treatment of OCD.
“TMS of several brain targets represents a safe and effective treatment option for OCD patients,” the investigators concluded. “Further studies are needed to help clinicians to individualize TMS protocols and targets for each patient."
Grassi G, Moradei C, Cecchelli C. Will transcranial magnetic stimulation improve the treatment of obsessive-compulsive disorder? a systematic review and meta-analysis of current targets and clinical evidence. Life (Basel). 2023;13(7):1494.
Brain Stimulation Treatment for Bipolar Disorder
Investigators provided an up-to-date overview of research on the efficacy, tolerability, and cognitive effects of different brain stimulation treatments for bipolar disorders, including TMS, transcranial direct current stimulation (tDCS), deep brain stimulation (DBS), vagus nerve stimulation (VNS), electroconvulsive therapy (ECT), and magnetic seizure therapy (MST). They discussed the challenges in treating bipolar disorders and highlight the need for more research to improve the effectiveness of these treatments.
“The evidence base for brain stimulation as an add‐on or alternative to pharmacological and psychological treatments in patients with bipolar disorders is limited but rapidly expanding,” the investigators concluded. “Brain stimulation treatments represent an opportunity to treat all bipolar disorder states, including cognitive dysfunction during euthymic periods.”
Mutz J. Brain stimulation treatment for bipolar disorder. Bipolar Disord. 2023;25(1):9-24.
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